穴位注射黄芪注射液治疗肺脾气虚证支气管哮喘慢性持续期疗效及对Th1/Th2平衡的影响

Efficacy of acupoint injection of Huangqi injection on chronic persistent bronchial asthma with syndrome of lung spleen deficiency and its influence on Th1/Th2 balance

目的 探讨穴位注射黄芪注射液治疗肺脾气虚证支气管哮喘慢性持续期的临床疗效及对Th1/Th2平衡的影响。方法 选择2020年12月-2022年3月上海市宝山区中西医结合医院收治的94例肺脾气虚证支气管哮喘慢性持续期患者,将患者随机分成2组,对照组在常规西医治疗基础上联合生理盐水足三里穴位注射治疗12周,观察组在常规西医治疗基础上联合黄芪注射液足三里穴位注射治疗12周。观察比较2组治疗12周后中医症状积分、哮喘控制测试(ACT)评分、血清总IgE、外周血嗜酸性粒细胞(EOS)计数、EOS比例、肺功能指标[第一秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)、呼出气一氧化氮(FeNO)]、外周血Th1/Th2细胞因子[白细胞介素-2(IL-2)、肿瘤坏死因子(TNF)-α、干扰素(IFN)-γ、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平及Th1/Th2]及临床疗效、治疗安全性。结果 2组治疗后各项中医症状积分,血清总IgE、外周血EOS计数、EOS比例、FeNO水平及血清IL-4、IL-6、TNF-α、IL-10水平均明显降低(P均<0.05),且观察组治疗后以上各评分和指标水平均明显低于对照组(P均<0.05);2组治疗后ACT评分及血清IL-2、IFN-γ水平均明显升高(P均<0.05),观察组治疗后Th1/Th2水平明显升高(P<0.05),且观察组治疗后明显高于对照组(P均<0.05);2组治疗后FEV_(1)、PEF均明显升高(P均<0.05),但治疗后组间比较差异均无统计学意义(P均>0.05);观察组总有效率为91.3%(42/46),高于对照组的68.2%(30/44),差异有统计学意义(P<0.05);2组治疗过程中均未发生明显不良反应。结论 黄芪注射液足三里穴位注射能有效改善肺脾气虚证慢性持续期支气管哮喘患者的临床症状,促进Th1/Th2平衡,有助于调节机体及气道的高敏状态,提高哮喘控制水平,保护肺功能,安全性良好。

Objective It is to investigate the clinical curative effect of acupoint injection of Huangqi injection on chronic persistent bronchial asthma with syndrome of lung spleen deficiency and its influence on Th1/Th2 balance.Methods Ninety-four patients with chronic persistent bronchial asthma with syndrome of lung spleen deficiency admitted to Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine from December 2020 to March 2022 were randomly divided into two groups.The control group was treated with acupoint injection of normal saline at Zusanli on the basis of conventional western medicine for 12 weeks,and the observation group was treated with acupoint injection of Huangqi injection at Zusanli on the basis of conventional western medicine for 12 weeks.After 12 weeks of treatment,the TCM symptom scores,asthma control test(ACT)scores,the levels of serum total IgE,peripheral blood eosinophil(EOS)count,EOS ratio,lung function indicators[first second forced expiratory volume(FEV_(1)),peak expiratory flow(PEF),fractional exhaled nitric oxide(FeNO)],peripheral blood Th1/Th2 cytokines[interleukin-2(IL-2),tumor necrosis factor(TNF)-α,interferon(IFN)-γ,interleukin-4(IL-4),interleukin-6(IL-6),interleukin-10(IL-10),and Th1/Th2]before and after treatment,as well as their clinical efficacy and treatment safety were compared between the two groups.Results After treatment,the TCM symptom scores,the levels of serum total IgE,peripheral blood EOS count,EOS ratio,FeNO,and serum IL-4,IL-6,TNF-α,IL-10 were significantly decreased in the two groups(all P<0.05),and the decrease of these indexes in the observation group was more significant than that in the control group(all P<0.05).After treatment,the ACT scores,the levels of serum IL-2 and IFN-γwere significantly increased in the two groups(all P<0.05),Th1/Th2 was significant increased in the observation group(P<0.05),and the increases in the observation group were more significant than those in the control group(all P<0.05).After treatment,FEV_(1) and PEF in both groups were increased significantly(all P<0.05),but there was no statistically significant difference between the two groups(all P>0.05).The total effective rate in the observation group was 91.3%(42/46),which was higher than 68.2%(30/44)in the control group,and the difference was statistically significant(P<0.05).No significant adverse reactions occurred during the treatment in both groups.Conclusion Acupoint injection of Huangqi injection at Zusanli acupoint can effectively improve the clinical symptoms,promote Th1/Th2 balance,help to regulate the hypersensitivity of the body and airways,improve the level of asthma control,protect lung function,and have good safety in the treatment of patients with chronic persistent bronchial asthma with syndrome of lung spleen deficiency.